jidjottings, by Lowell A. Goldsmith, MDhttps://jidjottings.wordpress.com
Musings on skin and the universeFri, 18 Aug 2017 04:47:58 +0000enhourly1http://wordpress.com/https://s2.wp.com/i/buttonw-com.pngjidjottings, by Lowell A. Goldsmith, MDhttps://jidjottings.wordpress.com
If Taylor Swift and Justin Bieber Wrote a Grant, Would the NIH Fund It? — OR — How Much Outside-the-Box-Thinking Should the NIH Support?https://jidjottings.wordpress.com/2015/12/15/if-taylor-swift-and-justin-bieber-wrote-a-grant-would-the-nih-fund-it-or-how-much-outside-the-box-thinking-should-the-nih-support/
https://jidjottings.wordpress.com/2015/12/15/if-taylor-swift-and-justin-bieber-wrote-a-grant-would-the-nih-fund-it-or-how-much-outside-the-box-thinking-should-the-nih-support/#respondTue, 15 Dec 2015 15:27:43 +0000http://www.scilogs.com/jid/?p=1827Continue reading If Taylor Swift and Justin Bieber Wrote a Grant, Would the NIH Fund It? — OR — How Much Outside-the-Box-Thinking Should the NIH Support?→]]>By Guest Blogger Robert Dellavalle, MD, PhD, MSPH, Associate Professor of Dermatology and Public Health, University of Colorado and the Colorado School of Public Health

“To maintain our edge . . . we’ve got to protect our rigorous peer review system and ensure that we only fund proposals that promise the biggest bang for taxpayer dollars . . . that’s what’s going to maintain our standards of scientific excellence for years to come.” –President Barack Obama on the 150th Anniversary of the National Academy of Sciences, April 29, 2013

Peer review may be scientifically untested, expensive, unreliable, and biased [Guthrie et al. 2015; Ginther et al. 2011], but it’s the best we’ve got–so let’s not tweak it too much. That’s the gist of a recent New England Journal article examining current National Institutes of Health (NIH) peer review processes for reviewing grants [Lauer and Nakamura, 2015]. Support for the status quo defaults from the lack of acceptable proven alternatives. Alternative grant rewarding systems do exist: one example is awarding grants according to the past performance and creativity of applicants (as the MacArthur Awards do), and another example is creating milestone competitions to reach large end goals (as the Human Genome Project did). But the outcomes (number of publications, positive changes in clinical practice, etc.) of these alternatives have not been compared rigorously to the outcomes of selecting grants by peer review.

The NIH budget doubled 15 years ago. This expanded the number of science trainees, leading to more NIH grant applications from more people today. These applicants are also submitting more applications due to the increasingly competitive funding levels. This provides a dilemma for the NIH—with an ever-tightening budget, should it continue to fund high-risk projects that score highly with peer review or adapt other review systems that might better identify projects with greater scientific impact?

Fig 1. My cat, Spot, thinking outside the box.

Do you ever think outside the box (Fig.1)? My personal NIH funding history provides a case report of a high-risk proposal. At the start of my academic career my wife Lisa Schilling, like all good internists, was reading the New England Journal of Medicine in bed late one night and pointed out to me that a large randomized trial of statins for the prevention of heart disease noted a lower rate of melanoma in those receiving treatment. Ah ha! I thought—perhaps this was the magic bullet to cure melanoma—or at least a new chemopreventive agent. Since many large, high quality statin clinical trials had already been completed, I proposed examining the effect of statins using meta-analysis of individual patient data from those trials. I submitted the project to seventeen funding agencies and was reminded repeatedly of Alain de Botton’s quote “Most business meetings involve one party elaborately suppressing a wish to shout at the other: ‘just give us the money’.” In the end the NIH National Cancer Institute was the source of funding for my grant that found that statins were not the magic bullet for preventing melanoma [Freeman et al. 2006].

Subsequently my research has turned to another unconventional topic–educating tattoo clients about the risk of UV radiation for ruining their tattoos and the canvas for their body art (their skin). This time my collaborators and I have not considered another funder besides the NIH. So, given my experiences, I strongly favor the NIH funding high risk, outside-the-box projects despite the messiness. But the question of how best to achieve this goal will remain until rigorous methods compare alternative grant reviewing processes [Azoulay 2012].

Insects wear their bones on the outside of their bodies. Their so-called “exoskeletons” provide rigid support and structure for muscle attachments similar to our own skeletons. But the exoskeleton also performs functions similar to our skin. Like skin, the exoskeleton is composed of multiple layers with pores and hairs that create a buffer between the inside of an insect’s body and the outside world (Fig. 1). With literally millions of insect species on Earth, the unique properties of insect “skin” are only beginning to be explored.

The first clue that insect skin (or, cuticle) could offer new insights into the way we think about body coverings comes from studies on the Namib Desert beetle, Stenocara gracilipes. The Namib Desert is one of the driest places in the world, but the air above the desert floor can be saturated with fog that blows in from the ocean. When fog blows in, the Namib beetle stands on its head to expose small bumps on its abdomen that attract water. The rest of the abdomen is covered with waxy grooves that channel the water to the beetle’s mouth. Engineers have now mimicked this process to build new devices that pull fresh water out of the air in regions where drinking water is scarce.

A more recent discovery related to insect skin comes from studies on the Saharan silver ant, Cataglyphis bombycina. The silver ant forages at temperatures that would kill most other insects, but silver ants are able to withstand the heat using a special coat of hairs (yes, insects have hair, though insect hairs are somewhat different from those in mammals). The hairs of the silver ant reflect most wavelengths of light but are nearly transparent to mid-infrared radiation—the wavelength ants emit as heat. This trick allows silver ants to reflect heat when they are in the open and then shed excess heat when they find a patch of shade.

Over the past semester, a group of students I have been working with at North Carolina State University have also become interested in the body coverings of ants. For hundreds of years, scientists have used differences in ant cuticle patterns to tell species apart, but very little is known about what these patterns do for the ants. We had a hunch that differences in ant cuticle could affect how species deal with pathogens, and we are now studying this in a genus of Australian ants that wildly differ in their cuticle structure (Fig. 2). We are extending this project to work with students from arts and design to make a catalog of different cuticle patterns. This is the first step in what we hope is a deep investigation into the properties of insect cuticle.

Ant portraits, Credit: AntWeb (https://www.antweb.org.) These images are made available under a Creative Commons license.

One of Yogi’s famous quotes — or misquotes — is that “it is very tough to make predictions, especially about the future.” Hywel Williams is one of Dermatology’s experts in explaining the present and predicting the future of health related events using quantitative data. He has been given the responsibility for directing the NIHR Health Technology Assessment Program for the UK National Health Service. Essentially all 400+ current major clinical trials within all medical specialties will be under his purview. A wonderful recognition of his analytical skills and his ability to put together large groups of investigators in endeavors such as the International Cochrane Skin Group systematic reviews and various national clinical trials within the UK Dermatology Clinical Trials Network, which he founded. Hywel likes to understand and predict events, so it is important to understand the path that brought Hywel to this next stage of his academic life.

Hywel Dda (Hywel the Good)

Even more important than Hywel’s horoscope, which is still being crunched by my supercomputer, is the name “Hywel.” “Hywel” is Welsh for ‘eminent’ or ‘remarkable’; thus he was given his life’s direction from the get-go by his family. Hywel comes from the small hillside village of Cymmer Afran in South Wales, and he attended a tiny comprehensive school there. Hywel Dda (meaning “Hywel the Good”) was a ninth century Welsh king whose major accomplishment was codifying Wales’ laws and customs and for ensuring equal rights for women. Yes, our Hywel has followed the direction of his namesake king and has given extraordinary service in codifying clinical trial data and global burden of disease, both in the United Kingdom and internationally.

Just go through Pubmed listings for HC Williams and you cannot help being impressed by the extent and breadth of his interests and accomplishments. In addition to the big picture items, Hywel’s most recent paper in the British Journal of Dermatology (2015) looks at the micro-level on how to improve teleconferencing; for him no issue is too big or too small to be studied and improved. His multiple accomplishments and awards are easily searchable on the University of Nottingham web site. When I was the Editor of the JID, Hywel was clinical trials Editor, and he improved the Journal‘s approach to clinical trial data and publication. His service to our specialty has been extraordinary and exemplary.

We know that the entire British National Health Service and the individuals it serves will benefit from having Hywel in his new position. Although Hywel comes from Nottingham, he is no Robin Hood and will be judicious in supervising the reviewing and awarding grants for clinical research. It is his nature and in his name.

Welcome back to Montagna, 2015! The conference keeps getting better and better!

The morning session, chaired by John McGrath, focused on stem cell-based therapies and innovative reprogramming technologies. In this session, it seemed almost possible to glimpse the future — a future where monogenic disorders of the skin like epidermolysis bullosa might be treatable! John reported on remarkable responses to cell-based therapies which led to life-changing improvements in the quality of life for his patients. Angela Christiano followed with a story about the next generation of 3-D skin models that she is developing that include not only keratinocytes and fibroblasts, but also melanocytes, nerve cells, and even rudimentary hair follicles. Jakub Tolar, a bone marrow transplant (BMT) expert from the University of Minnesota then showed truly amazing responses in recessive dystrophic epidermolysis bullosa with BMT. He demonstrated that stem cells derived from the BMT donor were able to differentiate and populate the skin and that these cells were able to produce collagen VII and improve clinical results in patients. Finally, Tony Oro presented clinical trial results from the Stanford dystrophic EB trial and showed new advances being made in adenoviral-driven reprogramming of autologous cells for therapeutic benefit. Taken together, these talks demonstrate the progress that is being made on all fronts, through the use of stem cells, for the benefit of these patients. It is one of the most optimistic and hopeful times I have seen for this class of disease.

The meeting ended with a bang – in keeping with tradition. Xiao-Jing Wang, from University of Colorado, revealed her new mouse model for patient-derived xenografting. One of the major limitations of the PDX mouse models is the need to use immunosuppressed mice in order to prevent rejection of the human tumor grafts. The immunocompromise in the traditional model eliminates the possibility of investigating the role of the immune system in the cancer progression and does not permit the investigation of immunotherapies. Xiao-Jing has now not only xenografted immunocompromised mice with human squamous cell carcinomas, but also used stem cells harvested from the same donor to reconstitute (or humanize) the mouse immune system. The same patient’s cancer graft is then removed and re-transplanted into the matched humanized mouse. In short, this is a new personalized model of the patient’s own tumor and immune system and opens up the possibility for testing novel drugs and drug combinations to predict response of the tumor to therapy, even immunotherapy. This is truly a preview of personalized medicine.

The last elements of the meeting included a panel discussion that was very lively. Topics included how to compete more successfully for grants, how to publish successfully, and how to position yourself for getting the job of your dreams after you finish your post-doctoral fellowship. I hope the young students and investigators in the room “felt the love” – those more senior members in the room were clearly committed to helping them become a successful next generation of investigators!

The finale of the meeting was a Potlatch Northwest-Style Salmon Barbeque at the home of Drs. Diane and Jim Baker. Just like the science at the meeting, life doesn’t get much better than this!

]]>https://jidjottings.wordpress.com/2015/10/21/stem-cells-at-the-montagna-symposium-on-the-biology-of-skin-part-ii/feed/0MSBS-logojidjottingsPhotograph of Sancy LeachmanStem Cells at the Montagna Symposium on the Biology of Skinhttps://jidjottings.wordpress.com/2015/10/20/stem-cells-at-the-montagna-symposium-on-the-biology-of-skin/
https://jidjottings.wordpress.com/2015/10/20/stem-cells-at-the-montagna-symposium-on-the-biology-of-skin/#respondTue, 20 Oct 2015 19:39:25 +0000http://www.scilogs.com/jid/?p=1801Continue reading Stem Cells at the Montagna Symposium on the Biology of Skin→]]>

GUEST BLOGGER: Sancy Leachman, Oregon Health & Science University

I am blogging today from the Montagna Symposium of the Biology of Skin. As most dermatologic scientists know, Montagna is developed each year as a new, independent specialty symposium, led by experts in the field, focusing on cutting-edge science that impacts the field of dermatology. The specialty topic for this year is stem cells – understanding the biology of these cells, and figuring out how to harness them to treat disease. The venue this year is spectacular, sequestered on the Oregon Coast, where we are sharing ideas, learning from each other, developing enduring relationships with collaborators, having a great time! I was incredibly “wowed” by all of the talks this year and can’t do justice to the program in this post, but you can see for yourself what the Symposium Director, Molly Kulesz-Martin and the Program Chairs Xiao-Jing Wang and Valery Horsley were able to accomplish by looking at the program online. Science in dermatology doesn’t get much better than this!

I wasn’t able to get out to the coast in time for the keynote lecture this year because I just launched a new app (Mole Mapper)

Missing Haifan Lin discuss the story of piRNAs and how they are uniting major constituents of our genome was a major disappointment for me. Fortunately, he was willing to sit with me and Valerie over a glass of Oregon wine the next evening and share his “elevator speech” about piRNAs. Anyone who isn’t familiar with the functional importance of these areas of the genome (that had previously been characterized as “junk DNA”) should get up to speed – it is an important, expanding area of human genetics that is certain to have direct implications on human health. One of my favorite lectures so far was Melissa (Missy) Wong’s talk on cancer stem cell and macrophage fusion. It was impressive because it provided direct evidence for a concept that one of my favorite melanoma biologists, John Pawelek, has been trying to prove, for almost two decades. In fact, David Norris made the point (during a robust question and answer session) that John had proposed this hypothesis at a joint Montagna/Pan American Society of Pigment Cell Research Conference about 17 years ago. This illustrates how difficult these important observations can be to understand and prove, how deeply and passionately our scientists think and feel about their contributions to the field, and how important questions must sometimes wait for technological breakthroughs to be answered. Missy provided us with compelling evidence that melanoma and other human cancer cells fuse with macrophages, potentially explaining how cancer cells gain the ability to metastasize. This discovery will impact the full spectrum of dermatologic science, from the perspective of understanding basic biology, providing possible diagnostic clues, and ultimately, perhaps allowing the development of new targeted agents in the future.

Another provocative talk for me was by Matthew Rodeheffer, an adipocyte stem cell biologist from Yale. His presentation brought an important diversity to the conference, expanding the horizons of cutaneous biologists and opening our eyes to ways that skin interfaces and/or recapitulates virtually every organ system in the body. There are so many areas in which nutrition and obesity affect human health (and disease). The contribution Matthew has made to understanding how specific dietary fats impact the expansion of adipocyte precursors and lead to obesity is relevant not only to medicine in general, but dermatology as well.

Congratulations to all of the speakers and meeting attendees – the conference is fabulous!

]]>https://jidjottings.wordpress.com/2015/10/20/stem-cells-at-the-montagna-symposium-on-the-biology-of-skin/feed/0MSBS-logojidjottingsPhotograph of Sancy LeachmanHow Does Science Happen? The Basal Cell Nevus Sagahttps://jidjottings.wordpress.com/2015/10/02/how-does-science-happen-the-basal-cell-nevus-saga/
https://jidjottings.wordpress.com/2015/10/02/how-does-science-happen-the-basal-cell-nevus-saga/#respondFri, 02 Oct 2015 11:16:07 +0000http://www.scilogs.com/jid/?p=1796Continue reading How Does Science Happen? The Basal Cell Nevus Saga→]]>Was Newton sitting under an apple tree? Was Kekulé dreaming while snakes were forming benzene rings during his rapid eye movements? Hard to say, it was a long time ago. That is why it is especially interesting to have a contemporary scientific narrative told by one of the key movers within the story. The October 2015 issue of JID includes an editorial by Ervin Epstein, Jr., who has been thinking of, dreaming of, and exploring the secrets of the basal cell nevus syndrome in the laboratory. He has been a great networker, even before the notion of networking was named, and he has interacted with clinicians and basic scientists throughout the world, as documented in his editorial. He starts with thoughts induced by sleep — or possibly hypoxia — on a transcontinental flight, reading, and integrating models and information from other diseases. Key steps of interacting with drug companies and convincing the money managers that basal cell nevus syndrome is important and that it could help their bottom line are expounded. The story is still in progress, so it is useful for the historians who will be digging though his emails and laboratory notebooks that Erv has shared his narrative in this issue.

Credit: Image credit: copyright Macrovector on Shutterstock.com

]]>https://jidjottings.wordpress.com/2015/10/02/how-does-science-happen-the-basal-cell-nevus-saga/feed/0lightbulbjidjottingsEinstein’s Grandchildren Revisit Space and Timehttps://jidjottings.wordpress.com/2015/08/05/einsteins-grandchildren-revisit-space-and-time/
https://jidjottings.wordpress.com/2015/08/05/einsteins-grandchildren-revisit-space-and-time/#respondWed, 05 Aug 2015 20:29:17 +0000http://www.scilogs.com/jid/?p=1787Continue reading Einstein’s Grandchildren Revisit Space and Time→]]>Our last post explored the international space station and its effect on mouse hair growth. Now we go 1400 light years further into space — and the future — to Kepler 452b, a time and distance trip, with blogger Paul Kantor. Time travel and prediction of the future of mankind is a popular genre — Thomas More’s “Utopia” (1516), Jules Verne‘s “Twenty Thousand Leagues Under the Sea” (1864), and George Orwell’s “1984” (1949) are just a few of the science fiction works popular with my generation in the 1950s. Describing the distant future requires both discussing a scientific and technical environment and the political and social structures of a new time and place. Aldous Huxley (“Brave New World”, 1932) would have appreciated the fate of flash drives and ‘bks’ in Kantor’s future earth.]]>https://jidjottings.wordpress.com/2015/08/05/einsteins-grandchildren-revisit-space-and-time/feed/0Kepler452bjidjottingsTrip to Space Station Grows Hair on Male Micehttps://jidjottings.wordpress.com/2015/07/07/trip-to-space-station-grows-hair-on-male-mice/
https://jidjottings.wordpress.com/2015/07/07/trip-to-space-station-grows-hair-on-male-mice/#respondTue, 07 Jul 2015 17:33:10 +0000http://www.scilogs.com/jid/?p=1782Continue reading Trip to Space Station Grows Hair on Male Mice→]]>Some experiments are not easy to perform. Consider a recent publication reporting six mice sent to live 91 days on the international space station (ISS) while their control group was on earth. (Neutelings et al, 2015) Alas, one mouse did not survive lift off, and two others died during the mission. Do not criticize the investigators because of the small number of animals involved or the fact that they were all males. Instead, concentrate on the most interesting finding for those earthbound humans who are developing baldness: the increased number of anagen (growing follicles) in the mouse in space. Hence, the mouse exposed to microgravity and other environmental factors on the ISS had dramatically increased transcripts associated with growing hairs.

Homo sapiens in space commonly experience skin injuries. One human experiment in progress involves one twin on earth and one in the station. There are returning human astronauts, and their hair could be checked for anagen/telogen ratio (a rather benign test). It is unclear whether the cost of sending someone to sit in the station is a high price to trigger their hair into anagen. For some, more hair at any price may be worth it. More studies can determine if more hairs are entering anagen or whether they are not leaving anagen.

This is a set of experiments that should be followed closely, and maybe balding individuals can donate their dimes and dollars to sponsor experiments such as these during long voyages on the station — or even longer voyages to Mars.

]]>https://jidjottings.wordpress.com/2015/07/07/trip-to-space-station-grows-hair-on-male-mice/feed/0JID-mouse space suit-printjidjottingsNo Hair Works Alone—Hair Plucking and Growthhttps://jidjottings.wordpress.com/2015/06/16/no-hair-works-alone-hair-plucking-and-growth/
https://jidjottings.wordpress.com/2015/06/16/no-hair-works-alone-hair-plucking-and-growth/#respondTue, 16 Jun 2015 11:00:17 +0000http://www.scilogs.com/jid/?p=1771Continue reading No Hair Works Alone—Hair Plucking and Growth→]]>Plucking of mouse hair is often used in the laboratory to investigate the hair cycle and sometimes to remove the pelage covering the skin before applying chemicals, drugs, ultraviolet irradiation or other components of the experimental tool box. An article by a cross-disciplinary team composed of dermatologists, stem cell biologists, developmental biologists, immunologists, mathematical biologists, and tissue engineers have worked together from diverse regions including the US, Taiwan, People’s Republic of China, and the UK. The result is a stimulating article in CELL about a simple principle underlying the population regenerative behavior in a complex biological system (Chen et al., 2015).

Important points:

Plucking hairs stimulate regeneration of both plucked follicles and unplucked adjacent follicles at some distance by some signals sent out from plucked follicles.

The immune system plays an essential role in this regenerative process. Hair follicles produce proinflammatory cytokines, including the chemokine CCL2, which attracts inflammatory macrophages with tumor necrosis factor alpha. These macrophages are necessary for spreading the signal afar, achieving the two-step signaling propagation.

Mathematical modeling of this system is consistent with the process of quorum sensing. Quorum sensing behaviors are often seen in bacteria and social insects such as ants and bees. Here, hair regeneration is shown as an interesting and important quorum phenomena in a mammalian system. “Quorum” in such systems describes a condition in which numbers of individual cells, organisms, or organs (e.g., hair follicles) are necessary for a change rather than an absolute level of chemical mediator.

NF-kappa B is one of the important mediators that stimulate hair regeneration.

In addition to the detailed mechanism that functions after hair plucking, this article shows that mathematical modeling analyses can helps to reveal a deeper level of understanding of skin diseases.

The institutional origin of the investigators is a perfect demonstration of the importance of involving multiple disciplines in research, as well as the broad international nature of skin-related and all research.

As investigators use wax or plucking to remove hairs to study their own hypotheses, they must be cognizant of all the quorum processes going on beneath the skin surface.

Hair disorders and organs beyond the skin may be co-opting the evolutionarily conserved quorum sensing principles for health or disease.

Differences in visible skin pigmentation are a major determinant of skin color associated with ethnic background. The initial goal of this study (Yin et al, 2014) performed on epidermal extracts from individuals of Caucasian, Asian, and African ancestry, was to identify differentially expressed genes with a special focus on known pigment-related genes. However, only a few of them were found to be significantly differently expressed, such as FRZB, CDH12, SOX5 and KITLG. The major result was that the skin of Caucasians and Asians had highly similar gene expression patterns that differed significantly from the pattern of African skin. Interestingly, ADRA2C (α-2C adrenergic receptor) had a high expression level in African skin but low expression levels in Asian and Caucasian skin. α2-adrenoceptors are G-protein-coupled receptors that mediate many of the physiological effects of norepinephrine and epinephrine and they can regulate skin color in zebrafish (Ruuskanen et al, 2005). In humans, their so far unsuspected role in the regulation of pigmentation needs further investigation. NINL was found to be expressed at a significantly different level in Caucasian and Asian skin, in which comparable melanocyte populations and very similar melanin contents have been found. NINL has been shown to be involved in microtubule organization, and high levels of NINL expression cause lysosomes to disperse towards the cell periphery (Casenghi et al, 2005). Since melanosomes are lysosome-related organelles and their distribution is regulated by various cytoskeletal components, including microtubules, the authors hypothesize that the higher expression level of NINL in Asian skin might play a critical role in the different distribution patterns of melanosomes that result in visible skin color differences

Psoriatic skin is characterized by an enhanced protective epidermal shield of antimicrobial peptides and proteins (AMPs). It is commonly believed that enhanced AMP levels in the skin from psoriasis patients, in contrast to those of atopic dermatitis patients, confer resistance to skin infections (Gambichlet et al, 2008; Ong et al, 2002; Howell et al, 2006). However, if bypassed through penetrating injuries, epidermal AMPs are not sufficient to protect from bacterial soft tissue infection, as reported by Steinz et al (2014). This clinical observation goes against the paradigm that AMPs provide antimicrobial resistance and highlights that the route of infection and not local AMP deficiency may contribute to disturbed skin immunity. In addition, it remains to be determined whether topical psoriasis treatments, such as vitamin D derivatives or steroids, may inhibit the cutaneous immune system, resulting in enhanced infection susceptibility.

Stress and itch: Understanding the psychological aspects is important

The main complaint of patients suffering of atopic dermatitis is itch. Stress is understood to diminish the perception threshold of itch in this and many other diseases. However, it remained unclear which factors could explain this relationship.

Schut et al. wondered if certain coping strategies could be activated under stress. Coping can be defined as adaptable thoughts and behaviors intended to manage subjective demanding experiences. They investigated the role of coping as a possible mediating factor between stress and itch in patients with atopic dermatitis. Coping and itch were assessed by self-report measures, while stress was not only measured by a validated questionnaire, but also by a physiological stress marker, the post-awakening level of cortisol. Using a regression- and a mediation analysis, this study showed a relationship between perceived stress and itch, which was fully mediated by negative itch-related cognitions. More than 62% of the variance of itch intensity could be explained by negative itch-related cognitions.

These findings help to explain the positive effects of cognitive restructuring in the treatment of chronic itch. They provide a further scientific rationale for cognitive restructuring in the treatment of atopic dermatitis.

Hair Follicles’ Promise in Wound Healing

Jimenez et al.’s interesting essay, “Reflections on how wound healing-promoting effects of the hair follicle can be translated into clinical practice,” reviews experimental and clinical evidence regarding the potential benefits of using hair follicles in wound healing, and possible common pathways with hair cycling, including the role of molecular and cellular mechanisms.

The authors provide examples of the use of hair-related therapies to manage chronic wounds, such as cultured epidermal autografts obtained from the outer root sheath, and hair-bearing donor skin. Although the essay focuses on the influence of hair biology in wound healing, the points discussed are also applicable to therapies for depigmenting disorders and hair neogenesis for cicatricial alopecias, among others.

While the clinical evidence is still preliminary, in our opinion further research in hair biology may provide greatly needed new and effective wound healing therapies.

Submitted by Katherine L. Baquerizo Nole and Robert S. Kirsner, University of Miami, Miami, Florida, USA